? 4/10 Silver AMPS 209 PMPS 239 +2=292 +4=286 Ketones 3.5!

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Question - will he still eat if his mouth is sore? If he won't eat then we are right back where we landed up on Friday. DKA..

Can't ever say for sure what any individual cat will do :rolleyes:, but all the cats I have ever brought in for a dental charged directly for the food bowls as soon as they got home, despite the after-care instructions that said to gingerly "offer small amounts of food" at first. So that wasn't a problem, at least for them. They do have to be fasted overnight for the anesthesia, so you will want to work closely with the vet to make sure that the fasting time is kept to the absolute minimum, and figure out how to dose insulin on the day (when the time gets closer, lots of folks here have done this with their diabetic cats).

That is frustrating, dealing with your vet! I'm really glad you are getting the ketone meter and will be able to test. Silver is doing great so far, so hopefully he won't have any recurrences, but if he does that meter will help make sure that any problems are caught quickly. Makes a world of difference in terms of treatment.

Would be nice to know what the trigger was for this last episode, though.
 
Can't ever say for sure what any individual cat will do :rolleyes:, but all the cats I have ever brought in for a dental charged directly for the food bowls as soon as they got home, despite the after-care instructions that said to gingerly "offer small amounts of food" at first. So that wasn't a problem, at least for them. They do have to be fasted overnight for the anesthesia, so you will want to work closely with the vet to make sure that the fasting time is kept to the absolute minimum, and figure out how to dose insulin on the day (when the time gets closer, lots of folks here have done this with their diabetic cats).

That is frustrating, dealing with your vet! I'm really glad you are getting the ketone meter and will be able to test. Silver is doing great so far, so hopefully he won't have any recurrences, but if he does that meter will help make sure that any problems are caught quickly. Makes a world of difference in terms of treatment.

Would be nice to know what the trigger was for this last episode, though.
Silver usually doesn't eat after 10:30pm until his breakfast at 6am so am guessing he just misses breakfast. Is that safe? Would missing one meal cause DKA again? I would have to drop him off at the vet at 8am on a work day and pick him up on my way home at 6:30pm. So that would be 20 hrs without food. Scary.
 
Question - will he still eat if his mouth is sore?

All my kitties and dogs have gone straight the bowl after a dental. They are starved after fasting. I would assume that if he is stable from the DKA, that that one fast will not bring on a DKA episode but I am not an expert. Plus, I have read here that they will still get a half dose before surgery.

If the dental is the issue...you need that inflammation/infection removed. That is the one hidden thing that can drive up BG and is one of the ingredients for DKA. To me, that is the bigger risk over the long term then fasting for a day.

My Civvie was sore but she had some big extractions right at the front of her mouth. That said she ate about half her normal food that night and by the next day was eating normally until the metacam set her off. Even then, shot of cerenia and she was eating normally within 24 hours. I gave her 2 bupe shots. She went CRAAAZZZY on it. That was the end of that. So the two days she got it.

Don't panic about the details of a dental till you get there. I know you like to have things all firm in your mind...but just focus on Silver and your rest for now.
 
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Silver usually doesn't eat after 10:30pm until his breakfast at 6am so am guessing he just misses breakfast. Is that safe? Would missing one meal cause DKA again? I would have to drop him off at the vet at 8am on a work day and pick him up on my way home at 6:30pm. So that would be 20 hrs without food. Scary.

Yeah, that's why I think you should work with the vet to try to shorten that time (have them offer a little food midafternoon before you pick him up, for example). But in any case, you aren't going to do the dental for a while, when he's fully recovered from the DKA and put on some weight too (the skinniness might have been a contributing factor here, he'll be more robust when he's back up closer to his normal weight). Lots of time to get a plan in place.
 
All my kitties and dogs have gone straight the bowl after a dental. They are starved after fasting. I would assume that if he is stable from the DKA, that that one fast will not bring on a DKA episode but I am not an expert. Plus, I have read here that they will stick get a half dose before surgery.

If the dental is the issue...you need that inflammation/infection removed. That is the one hidden thing that can drive up BG and is one of the ingredients for DKA. To me, that is the bigger risk over the long term then fasting for a day.

My Civvie was sore but she had some big extractions right at the front of her mouth. That said she ate about half her normal food that night and by the next day was eating normally until the metacam set her off. Even then, shot of cerenia and she was eating normally within 24 hours. I gave her 2 bupe shots. She went CRAAAZZZY on it. That was the end of that. So the two days she got it.

Don't panic about the details of a dental till you get there. I know you like to have things all firm in your mind...but just focus on Silver and your rest for now.
Sounds good. But if it is a tooth problem then the dental needs to be a priority right? I have an appointment for the dental exam on Saturday. Metacam is the pain meds right? I can't even say I don't want it because it has a bad effect as Silver hasn't had it before.
 
That does sound like a reasonable cost for the dental. I'm sorry your vet is being so ridiculous. I hope Silver will continue to get his strength back and you'll be able to get the dental done soon. Sending prayers.
 
Yeah, that's why I think you should work with the vet to try to shorten that time (have them offer a little food midafternoon before you pick him up, for example). But in any case, you aren't going to do the dental for a while, when he's fully recovered from the DKA and put on some weight too (the skinniness might have been a contributing factor here, he'll be more robust when he's back up closer to his normal weight). Lots of time to get a plan in place.
Trouble is I don't know what caused the DKA and if it's the teeth then dental must be a priority. I could take a sick day I guess but I'd prefer not to.
 
How much Recovery should I be feeding him? I'm off to get some more cans from the vet. Was given three. Gave him a full can yesterday as well as two cans of FF. He did have a bit of runny poo this am.
 
priority right?

After he recovers from the DKA. That is going to take him a few of weeks.

The runny poo can be from the new food and stress over the last few days. Hopefully that clears up over the next couple of days.

I thought I saw a post to give 1.5 normal calories. So with the FF how much more calories does he need. FF is around 85-90 calories per 3 oz can. Recovery has been 183 for a 5.5oz can. What is his ideal weight?
 
After he recovers from the DKA. That is going to take him a few of weeks.

The runny poo can be from the new food and stress over the last few days. Hopefully that clears up over the next couple of days.

I thought I saw a post to give 1.5 normal calories. So with the FF how much more calories does he need. FF is around 85-90 calories per 3 oz can. Recovery has been 183 for a 5.5oz can. What is his ideal weight?
Ok just back from vet. Told to give 1/2 a can of the recovery along with his regular food at normal amounts.

Seeing vet on Saturday re dental exam and will see what he says. If he sees them bad enough then he may say do dental now. The vet I am seeing Saturday is not the same as the ones I have talked to so far and apparently he has experience doing dentals for diabetic cats. Let's hope he is nicer when I talk to him. He is on duty tomorrow and I have asked if they will have him read Silver's file and see if he can tell me what caused the DKA and be up-to-date with his conditions before we see him on Saturday.

Had to worm my way around getting a copy of his file. They told me to get it from the emergency vet. I told them they said to get from them. Little white necessary lie. I got the file. Will go over with fine tooth comb tonight.

How would I know his idea weight? I have no clue.
 
Morning Juliet.
Haven't yet properly caught up but it sounds like Silver is recuperating well.
Glad he is eating well & after snuggles.
That regular local vet sounds like he came out of the ark. Maybe the ER vet can suggest someone although I know transport is an issue.
You need a vet who can listen as well as be able to explain well & fully.
With regards to Silver's notes , records, lab results. They belong to you & you have a right to them.
I do know what it's like to have an intransigent vet though, as we started with that before a swapped to the vet I now solely see. Same teaching vet hospital as that is the only place really with the mod cons just younger model of vet.

M
 
Morning Juliet.
Haven't yet properly caught up but it sounds like Silver is recuperating well.
Glad he is eating well & after snuggles.
That regular local vet sounds like he came out of the ark. Maybe the ER vet can suggest someone although I know transport is an issue.
You need a vet who can listen as well as be able to explain well & fully.
With regards to Silver's notes , records, lab results. They belong to you & you have a right to them.
I do know what it's like to have an intransigent vet though, as we started with that before a swapped to the vet I now solely see. Same teaching vet hospital as that is the only place really with the mod cons just younger model of vet.

M
Well let's hope the one I see on Saturday is better. I think sometimes the less they know of what I am doing the better.
 
What does he weight now? The vet notes should have a weight. I know you said he is a little thin...but we can add some grams to it.

I am glad you got the notes.
I'll check the notes shortly and post.

Just got home, feeding him his Recovery/FF - he is lapping up like there is no tomorrow so appetite back to normal.

Not happy with the BG at all....I hope this is still the depot filling up?? Unfortunately I now know that the Accu-check is more in line with the lab.
 
I think sometimes the less they know of what I am doing the better.
:D:cool::D:cool:
wise words!
I do just like that - worked perfectly so far.
(I did not come up to this idea of behavior by myself - my vet's acting suggested it!, honestly!)

I, too would be curious to learn what caused the DKA episode but if the treatment is the same - I care not.

I'd try to beef up my cat's immune system in general - but not against any particular problem - as yo u said - "was it UTI that caused DKA? - well, try cranberries or vitamin C)" -no, not like that, but rather as a whole organism, strong enough to fight whatever infection, or other, is thrown at it.
I hope that Silver's good eating and hydrating will help him to regain enough of his natural strength to fight anything.
(And yes - vit C and cranberries are the huge help for the immune s., benefits the whole body - not the ur tract alone!)
 
:D:cool::D:cool:
wise words!
I do just like that - worked perfectly so far.
(I did not come up to this idea of behavior by myself - my vet's acting suggested it!, honestly!)

I, too would be curious to learn what caused the DKA episode but if the treatment is the same - I care not.

I'd try to beef up my cat's immune system in general - but not against any particular problem - as yo u said - "was it UTI that caused DKA? - well, try cranberries or vitamin C)" -no, not like that, but rather as a whole organism, strong enough to fight whatever infection, or other, is thrown at it.
I hope that Silver's good eating and hydrating will help him to regain enough of his natural strength to fight anything.
(And yes - vit C and cranberries are the huge help for the immune s., benefits the whole body - not the ur tract alone!)
Yup, the hydrating comes once Silver and I have both eaten and relaxed for an hour, then I will go and attempt second try at these fluids. I hate hate doing it and glad I only have to do it four more times.
 
Ok just back from vet. Told to give 1/2 a can of the recovery along with his regular food at normal amounts.

Seeing vet on Saturday re dental exam and will see what he says. If he sees them bad enough then he may say do dental now. The vet I am seeing Saturday is not the same as the ones I have talked to so far and apparently he has experience doing dentals for diabetic cats. Let's hope he is nicer when I talk to him. He is on duty tomorrow and I have asked if they will have him read Silver's file and see if he can tell me what caused the DKA and be up-to-date with his conditions before we see him on Saturday.

Had to worm my way around getting a copy of his file. They told me to get it from the emergency vet. I told them they said to get from them. Little white necessary lie. I got the file. Will go over with fine tooth comb tonight.

How would I know his idea weight? I have no clue.
This might help. It doesn't give weights but helps you judge where kitty is presently.
http://meowaum.com/602-cat-body-condition-score-chart/
My two boy cats are decent sized and look good at 13-14 lb.
 
:bighug: yeah..
When you do try to remember that Silver desperately needs this therapy and, unfortunately, you are the only one to do it for him.
I managed. Its done. Didn't drip it all over him...I do think I got it too far up his scruff though and may should have aimed lower? I was getting a little worried when the ball of fluids was almost on his head. Oh dear. Maybe I will get it right third time.

@Tracey&Jones the notes say his weight is 5.47 kg (which is 12lb). Sounds like a big cat? But I can feel his spine and bones. However, he was always a very chunky cat before diabetes.

I would scan the notes from the vet but there are 15 pages and my scanner only does one page at a time.

Have read the notes - some of it blatantly wrong. They said they discussed syringe feeding with me - they did not.
They said ketones remained unchanged overnight and was 4mmoL - this was written on Sunday morning. No further comment was made about keytones - wow...crazy. If they sent me home with him at 4mmoL - what was the point of hospitalisation? just to get him to eat? They said his BG had been down as low as 144 but that is on THEIR pet meter so must have been much lower than that on our human meters. Most of the time he hovered around 234 - again on their Alph-Trak.

So I don't think they lowered blood sugar, don't think they removed ketones - what the heck DID they do??

Am going to eat, then test him for ketones on the meter. A bit worried about what I might see. However, he is bright, perky and back to his normal self.
 
So I don't think they lowered blood sugar, don't think they removed ketones - what the heck DID they do??
what was done can only be answered if you compare the pre-admition and the at-the release blood work, IMHO. (one of the reasons I always suggest to get the whole file). I understand you were hesitant to put any kind of claim on freebies I've suggested on the other thread, but a copy of the file is your property, even if it's been paid for by the DCIN - they paid for in your behalf, so it is yours! (and theirs of course, should they've ever wished for it, which I doubt)
My vets in ER were successful in bringing Ducia's BG down whilst she was there - but it's not like fixing thing forever.
Ducia was in Pink and Reds right after - and yet, I am telling you honestly, that "stabilization at the ER" that cost DCIN more than my car 's worth - it's saved Ducia's life.
I am sure that the ER staff did something good for Silver, something that helped him being here.
Btw, one cannot "remove" ketones as such - but rather create conditions under which ketones would not like to reappear/expand.
That's means no infections, enough food and water and insulin in proper dose. All of which you are already doing.
 
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He will be after mine shortly - sweet and sour duck (NOT cat food!)

Woobie.jpg


:arghh:
 
the notes say his weight is 5.47 kg (which is 12lb). Sounds like a big cat? But I can feel his spine and bones. However, he was always a very chunky cat before diabetes.

Not really. Jones was around 5.75Kgs before all his issues. And he was a pleasantly plumb old man. Depends on their bone structure etc. My Fat Momma civvie is slim at 6kgs.

So let us aim for 5.75kgs for Silver. Adding some extra grams in to that 5.47kg, Jones IM vet told me a few extra grams is not a big deal and when dealing with a chronic condition would rather see a "plump" cat vs an ideal cat.

Calorie Calc = ideal weight in lbs x 13.5 +70

So calories 5.75*2.2*13.5+70=241 - So 250 calories a day roughly.

FF is around 90 calories per 3oz can - so two of those get you to 180.

Recovery is 183 calories per 5.5oz can - so 1/2 of that gives you another 90 calories.

There you go 270 calories plus any treats he gets.

This may be too much once his numbers come down but for now I think a little more than less is ok.

I am getting off the computer tonight as doing taxes after work and working on month end all day has my eyes very dry and sore. I hope you and Silver have a good night.
 
THIS is what's important.....stop trying to overthink it and enjoy your Sweet & Sour duck!

There isn't always a clear reason for DKA.....even a cat with totally normal blood glucose numbers can develop ketones.

As long as Silver is eating well, acting good and being a normal cat, be happy!!
OK. Agreed. I just checked his ketone levels with the new ketone meter I just got - and it said 3.5! How can that be good. It was 4 while he was in the hospital so obviously not much improvement in the ketone numbers. Am going to call the emergency vet back and ask how this can be okay.
 
what was done can only be answered if you compare the pre-admition and the at-the release blood work, IMHO. (one of the reasons I always suggest to get the whole file). I understand you were hesitant to put any kind of claim on freebies I've suggested on the other thread, but a copy of the file is your property, even if it's been paid for by the DCIN - they paid for in your behalf, so it is yours! (and theirs of course, should they've ever wished for it, which I doubt)
My vets in ER were successful in bringing Ducia's BG down whilst she was there - but it's not like fixing thing forever.
Ducia was in Pink and Reds right after - and yet, I am telling you honestly, that "stabilization at the ER" that cost DCIN more than my car 's worth - it's saved Ducia's life.
I am sure that the ER staff did something good for Silver, something that helped him being here.
Btw, one cannot "remove" ketones as such - but rather create conditions under which ketones would not like to reappear/expand.
That's means no infections, enough food and water and insulin in proper dose. All of which you are already doing.
I have the file. It does not help much. According to them he has no infection but we don't know that. We only know there is no UTI. He is eating and I am following SLGS so I can't increase insulin any faster than I am. He is getting the fluids from the bag they sent me home with and I am mixing water in with his food. HOWEVER he still has ketones of 3.5. This isnt good and I am upset.
 
Before I run as am late but want to place this note before I forget.

I believe some kitten foods may be OK for a diabetic cat and will help weight gain in the right way.

Perhaps the more experienced members can comment on that for Juliet.
 
Before I run as am late but want to place this note before I forget.

I believe some kitten foods may be OK for a diabetic cat and will help weight gain in the right way.

Perhaps the more experienced members can comment on that for Juliet.
Just bought 10 cans of Recovery. That should do the trick.
 
Not really. Jones was around 5.75Kgs before all his issues. And he was a pleasantly plumb old man. Depends on their bone structure etc. My Fat Momma civvie is slim at 6kgs.

So let us aim for 5.75kgs for Silver. Adding some extra grams in to that 5.47kg, Jones IM vet told me a few extra grams is not a big deal and when dealing with a chronic condition would rather see a "plump" cat vs an ideal cat.

Calorie Calc = ideal weight in lbs x 13.5 +70

So calories 5.75*2.2*13.5+70=241 - So 250 calories a day roughly.

FF is around 90 calories per 3oz can - so two of those get you to 180.

Recovery is 183 calories per 5.5oz can - so 1/2 of that gives you another 90 calories.

There you go 270 calories plus any treats he gets.

This may be too much once his numbers come down but for now I think a little more than less is ok.

I am getting off the computer tonight as doing taxes after work and working on month end all day has my eyes very dry and sore. I hope you and Silver have a good night.
Thanks. This is really helpful. Two cans of FF plus 1/2 can Recovery. I can do that.
 
Hey, :bighug::bighug:
please try to ratio your upset.
I have the file. It does not help much.
Can you take a pic/ photo of the test results you are looking on?
And post them here?

ETA: Frankly, I 'd prefer that you post it in the Lab Tab - just underneath the SS.
Is that ok?
 
Hey, :bighug::bighug:
please try to ratio your upset.

Can you take a pic/ photo of the test results you are looking on?
And post them here?

ETA: Frankly, I 'd prefer that you post it in the Lab Tab - just underneath the SS.
Is that ok?
It's 15 pages and I have no scanner so I don't know how I can.
 
So what about the 3.5 reading? I'm so scar d he's not safe.
there is no real reason to believe him unwell unless he stopped eating - and in combination with "off" behavior.
The 3.5 ketones reading is a bit questionable - was a sample taken under the stress or after Silver was stabilized in the ER? Who sampled it? Was urin that they've tested - a Urinalysis? Big difference ....
So I am nervous this DKA is not over.
:bighug::bighug::bighug: let's hope it is over....:)
 
there is no real reason to believe him unwell unless he stopped eating - and in combination with "off" behavior.
The 3.5 ketones reading is a bit questionable - was a sample taken under the stress or after Silver was stabilized in the ER? Who sampled it? Was urin that they've tested - a Urinalysis? Big difference ....

:bighug::bighug::bighug: let's hope it is over....:)
This was my test on the blood ketone meter I bought. Why would it be questionable?
 
Juliet, Bubba threw Ketones while he was in the 200 range. He went as high as 5.5 on the ketone meter. His ketone episode was after a dental with 2 extractions and then 6 weeks later his right eye was removed due to cancer. Surgery can throw a cat into ketones just from stress. Bubba had no infection at the time of the ketones. Like Sienne said, infection is just one possible component to a DKA scenario. We were lucky that Bubba did not stop eating through this and I had the guidance here to get more insulin in him safely to help bring him down. He did not have lethargy or vomiting. He was thin as he was starving to death and he ate like a horse through all of this. We were lucky that his ketone event did not go into a DKA event.

I was able to manage his ketones at home with lots of water in his food, enough insulin, but as I said Bubba always ate through all this which was our saving grace.

I would agree with the others and get him stable before taking him into a dental surgery setting.
 
Juliet, Bubba threw Ketones while he was in the 200 range. He went as high as 5.5 on the ketone meter. His ketone episode was after a dental with 2 extractions and then 6 weeks later his right eye was removed due to cancer. Surgery can throw a cat into ketones just from stress. Bubba had no infection at the time of the ketones. Like Sienne said, infection is just one possible component to a DKA scenario. We were lucky that Bubba did not stop eating through this and I had the guidance here to get more insulin in him safely to help bring him down. He did not have lethargy or vomiting. He was thin as he was starving to death and he ate like a horse through all of this. We were lucky that his ketone event did not go into a DKA event.

I was able to manage his ketones at home with lots of water in his food, enough insulin, but as I said Bubba always ate through all this which was our saving grace.

I would agree with the others and get him stable before taking him into a dental surgery setting.
Okay that makes sense. I'll keep adding water to food bit not sure what I do re insulin as I can't ever catch nadir until Saturdays. Hence me following SLGS. His numbers are not good but @Tracey&Jones said his depot needs replenished and it can take 6-8 cycles. I'm just scared I guess.
 
Juliet, Bubba threw Ketones while he was in the 200 range. He went as high as 5.5 on the ketone meter. His ketone episode was after a dental with 2 extractions and then 6 weeks later his right eye was removed due to cancer. Surgery can throw a cat into ketones just from stress. Bubba had no infection at the time of the ketones. Like Sienne said, infection is just one possible component to a DKA scenario. We were lucky that Bubba did not stop eating through this and I had the guidance here to get more insulin in him safely to help bring him down. He did not have lethargy or vomiting. He was thin as he was starving to death and he ate like a horse through all of this. We were lucky that his ketone event did not go into a DKA event.

I was able to manage his ketones at home with lots of water in his food, enough insulin, but as I said Bubba always ate through all this which was our saving grace.

I would agree with the others and get him stable before taking him into a dental surgery setting.
What if it's the teeth that caused the DKA?

I'm trying to figure out why the numbers went into yellows (from mostly blues) from the increase 3:50 to 4:25. Each increase has not had any affect. So if I don't do the dental and the teeth are the issue - won't the numbers stay high and therefore not get rid of the ketones? Ketones is a new unfamiliar area for me and I don't know what to do. I'm not convinced he is safe. I don't do TR so I am restricted with insulin increases. What do I do?
 
Ok the day is done and I am heading to bed. The ER vet did not call me back so I do not know if Silver is safe at 3.5 ketones in his blood. Thankfully he is eating. His BG numbers are the highest they have been in weeks and I am going to bed scared. Tomorrow is another day. I need those blue numbers back to feel he is safe. Should I wait for the curve at the weekend or increase now given the DKA situation??
 
The presence of ketones does not necessarily mean the cat is in DKA

DKA is the presence of ketones, electrolyte imbalances and blood gas results.

As long as he's eating well and acting fine, just keep an eye on them.....it takes time for them to completely clear out of the body.
Ok thanks. Maybe I'll sleep a little easier. I'm jumping at every sound from him.
 
Didn't they find he had a UTI? If so it takes about 72 hours for the AB to squash the bacteria.

Get some sleep. As long as he is eating and getting lots of water in his food and you're giving sub Q fluids try not to worry too much. The ketones can come and go. That's what happened with Bubba.
 
What if it's the teeth that caused the DKA?

Like others have said, he needs to stabilize from the bout of DKA before you want to give him anesthesia and surgery. It’s good that you are keeping the teeth issue on your radar and intend to address it, I know first hand what bad teeth can do to a cat. My thought with teeth in the meantime, I would inquire about a course of antibiotics that would be good at addressing common oral infections. It’s a bandaid but should be good enough to keep things at bay until you can get the dental.
 
Didn't they find he had a UTI? If so it takes about 72 hours for the AB to squash the bacteria.

Get some sleep. As long as he is eating and getting lots of water in his food and you're giving sub Q fluids try not to worry too much. The ketones can come and go. That's what happened with Bubba.
The culture came back clear. No UTI
 
Like others have said, he needs to stabilize from the bout of DKA before you want to give him anesthesia and surgery. It’s good that you are keeping the teeth issue on your radar and intend to address it, I know first hand what bad teeth can do to a cat. My thought with teeth in the meantime, I would inquire about a course of antibiotics that would be good at addressing common oral infections. It’s a bandaid but should be good enough to keep things at bay until you can get the dental.
Well both vets said no infection so didn't give any AB. I wish I knew what caused this because if I don't know the cause I won't know how to stop it happening again. All I am doing differeny is adding water to his food. His numbers are not good. I am so scared for him I feel I am having a panic attack at times. Silly I know.
 
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